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麻醉及手术应激期间的血浆肾素活性和血浆醛固酮与β-肾上腺素能阻滞(作者译)

[Plasma renin activity and plasma aldosterone during anaesthesia and operative stress and beta-adrenergic blockade (author's transl)].

作者信息

Wernze H, Hilfenhaus M, Rietbrock I, Schüttke R, Kühn K

出版信息

Anaesthesist. 1975 Nov;24(11):471-6.

PMID:2027
Abstract

In 21 patients undergoing ear operations associated with minimal bleeding plasma renin activity and plasma aldosterone concentration were studied before and during surgical procedure, and in the postoperative state. Studies were performed in two groups, one without (n=9) and one with beta-adrenergic blockade by Practolol (n=12). Plasma renin activity increased significantly during halothane anaesthesia alone whereas the surgical manipulations did not further influence mean values significantly. Thus, it seems to be established that anaesthesia per se influences renin secretion. On the other hand Practolol does not show an inhibiting effect. The plasma renin increase following anaesthesia is due to the hemodynamic including renal hemodynamic, changes as well as to activation of the sympatho-adrenal system. Changes in plasma aldosterone are variable. For the greater part of patients with beta-adrenergic blockade an increase during the operative procedure was found. However, in some patients especially in the control group, plasma aldosterone was unchanged or decreased in spite of increasing renin values. Significantly lower plasma potassium concentration in these cases seems to indicate the important contributing role of potassium for the short-term regulation of aldosterone secretion. Plasma sodium concentration remained unchanged for the periods studied.

摘要

对21例耳部手术出血量极少的患者,在手术前、手术过程中及术后状态下研究了血浆肾素活性和血浆醛固酮浓度。研究分为两组进行,一组未使用(n = 9),另一组使用心得宁进行β - 肾上腺素能阻滞(n = 12)。仅在氟烷麻醉期间血浆肾素活性显著增加,而手术操作并未进一步显著影响平均值。因此,似乎可以确定麻醉本身会影响肾素分泌。另一方面,心得宁未显示出抑制作用。麻醉后血浆肾素升高是由于包括肾血流动力学在内的血流动力学变化以及交感 - 肾上腺系统的激活。血浆醛固酮的变化是可变的。在大部分接受β - 肾上腺素能阻滞的患者中,手术过程中发现其升高。然而,在一些患者中,尤其是对照组中,尽管肾素值升高,但血浆醛固酮未改变或降低。这些病例中显著较低的血浆钾浓度似乎表明钾在醛固酮分泌的短期调节中起重要作用。在所研究的时间段内血浆钠浓度保持不变。

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